Immigration & Health Care

President Obama and Democratic members of Congress have stated that the health insurance plan being proposed will not cover those illegally in the U.S. "We're not going to cover undocumented aliens, undocumented workers. That issue is too politically explosive" said Sen. Max Baucus, D-Mont. Despite his assertion, the matter is ambiguous. Some plans being proposed to extend coverage to the uninsured contain no method of determining legal residency. Plans that do require proof of eligibility will rely on easily forged documents such as drivers licences and social security cards. The very same documents often used to fraudulently obtain jobs and other public services. Some states even provide drivers licences to illegal immigrants, further complicating the matter. There is little reason to suppose the federal government would be any more thorough in checking those documents, particularly if there is no sincere desire to authenticate those documents. While it may be true that the bill as worded may be interpreted as disallowing coverage to illegal immigrants, the issue is not so clear cut. An amendment put forward by Rep. Dean Heller, R-Nev., that would have prevented illegal aliens from receiving subsidized health care under the bill was defeated, further casting doubt on the government's determination to exclude illegal immigrants from receiving benefits.

Curiously, it is being argued that it is necessary to spend $1 trillion over the next decade to contain, not check, not reduce, but contain the costs of health care. And the costs are substantial. If immigration reform is not coupled with health care reform, the effort to contain costs will be even more futile. In 2004, almost $3 billion was spent providing health care to illegal immigrants in California, Virginia, Florida, and Texas alone. Transferring those costs to Washington does not reduce them. Neither will obscuring them in the details of a massive, trillion dollar, health care bureaucracy.

If and when national health care reform is enacted, is unlikely that Americans, or Congress will sit idly while 12 million illegal immigrants languish without health care. The only decent thing to do will be to extend health care to them. The cost of doing the decent thing will be high. The pressure illegal immigrants will put on the health care system is considerable. Since illegal immigrants bypass health care screening when they enter the country, some bring with them diseases nearly absent in the U.S. Leprosy, Malaria, and Dengue fever are among the diseases making a return to U.S. soil. There were only 900 cases of leprosy in the U.S. between 1962 and 2002. Between 2002 and 2005, there were 9,000 cases, mostly among illegal immigrants. 38 of 61 health districts in California have experienced cases of tuberculosis. Also largely among illegal immigrants. The rate of tuberculosis in Mexico is ten times that in the U.S. Drugs recently developed to combat a new strain of drug resistant TB are expensive, often running into the thousands of dollars. Other diseases that have shown up in immigrant populations are Chagas disease, hepatitis, and whooping cough. In the vast majority of instances, they were found among illegal immigrants. It is doubtful that many immigrants, legal or otherwise, would be able to afford the drugs needed to treat those illnesses, which leaves the states or the federal government to pick up the tab; something Obama and many in Washington are happy to do.

While providing free health care to illegal immigrants will help reduce the occurrence and spread of these diseases, it will not prevent their reintroduction, particularly since the presence of these diseases in illegal immigrants will often only be known when their symptoms become manifest. By then, it will already be too late since those diseases will already be here along with their host. Detecting, treating, and preventing the spread of these diseases, which would be the prudent thing to do, will add to health care costs. But in order to do this we will have to know who is here and where they are. Both are problematic endeavors when it comes to illegal immigrants.

As the number of illegal immigrants grows, and in the absence of immigration reform it will grow, there will be pressure brought to bear to provide them health care. Tales of their suffering and misery will sooner or later ring in the capitol and in the press and there will be an outcry that the plight of illegal immigrants be addressed. And if and when health care is extended to illegal immigrants, it will be yet another incentive for them to enter the U.S. If the situation were reversed, I would certainly try; particularly if I or a loved one were ill.

The demand for health care will only increase in the future. The cost of the plan will only go up. The rear guard actions being fought by Republicans will in time be overwhelmed. It will be morally difficult and politically dangerous to oppose the expansion of health care when it is deemed necessary to "justice" or required by human decency. To oppose an expansion or an increase in coverage would likely be portrayed as miserly or callous; two things politicians will go to great lengths to avoid being accused of.